Shaw, Mary M
Shaw, Mary M is an individual health care provider with primary practice located at 915 Vermont St , Quincy IL 62301-3049. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Shaw, Mary M can be contacted via phone (217) 222-8245.Contact Information
Primary practice address
915 Vermont St
Quincy IL 62301-3049
Phone: (217) 222-8245
Fax: (217) 222-4512
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | Illinois |
Profile Details
| NPI number | 1124210596 |
|---|---|
| LBN Legal business name | Shaw, Mary M |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2007 |
| Last updated | Aug 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124210596 | NPPES |
| Illinois | Other | 0000132022 | BLUE CROSS BLUE SHIELD |
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